Gardendale Civitan Scholarship Application
The Civitan Club of Gardendale is sponsoring a scholarship to an individual, who has a Down syndrome diagnosis,  is a member of Down Syndrome Alabama, has permanent residence in one of the surrounding counties of the Birmingham Metropolitan Area, and will be attending a post-secondary educational program at an institution of higher learning or trade school.

Like the Civitan Members, this recipient should be helpful, brave, and giving back to his or her community in order to make the world a better place.

This scholarship may not be deferred, is non-renewable, and will be paid directly to the institution for tuition only.  

Students will be notified by letter and will be expected to attend a Gardendale Civitan Club Meeting with their family to be officially presented their scholarship.  The deadline to submit an application is Friday, May 31. If you have any questions, please email missy@dsacares.org.
Email *
Name *
Mailing Address *
Phone Number *
Email Address *
Date of Birth *
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Parents' Names *
Parents' Addresses (if different from applicant) *
Parents' Phone Numbers *
Parents' Email *
County of Residence *
School System Attended *
High School Attended *
Graduation date *
Have you been accepted to a post-secondary educational program or trade school? *
Which program will you be attending? *
Address of the post secondary program or trade school you will be attending. *
Contact person and phone number of the post secondary program or trade school you will be attending. *
Please tell us a little about yourself. *
Please list any accomplishments, honors, awards, or community impact. *
Please describe your goals for the future. *
Please describe someone who has been influential in your life and why. *
The Civitan Club is dedicated to helping others. Describe a time you helped or served others AND how did that experience make you feel? *
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